Clinical Observation Of The Autologous Cartilage- Perichondrium Compounds Applying In Open Tympanoplasty

Objective.Contrast observe the Clinical curative effect of application of autogenous cavum conchae cartilage-perichondrium compounds and temporal fascia to repair tympanic membranein in open tympanoplasty(Canal wall down mastoidectomy+ tympanoplasty,+ear cavity angioplasty) to treat cholesteatoma or chronic suppurative otitis media.Methods:This research object data were selected from the first affiliated hospital of kunming medical university otolaryngology head and neck surgery between January 2014 and October 2015 which were diagnosed as cholesteatoma or chronic suppurative otitis media (72 cases).The research subjects were randomly divided into two groups:experimental group (36 ears) and the control group (36 ears).The experimental group:all patients Operation way is the open tympanoplasty(Canal wall down mastoidectomy+tympanoplasty,+ear cavity angioplasty), Appllying autogenous cavum conchae cartilage-perichondrium compounds to repair tympanic membranein. If the stape is preserved,we can make the cartilage-perichondrium compound cartilage surface contact with the stape,then take the temporal muscle fascia repairing tympanic membrane.The control group implement the same operation,Appllying temporal fascia to repair tympanic membranein.All patients were postoperative follow-up of 3 months to 6 months.Analysis of the experimental group and the control group tympanic membrane grow situation,different abnormal shapes(retraction, adherence and perforation) of tympanic membrane, cavity dry time after surgery, postoperative 3 months average air conduction audibility threshold (0.5 kHz,1.0 kHz,2.0 kHz,4 kHz).ResuIts:Tympanic membrane all grow well in the experimental group, the percentage of success is 100%,1 ear appears small tympanic membrane perforation, tympanic membrane healing rate was 97.22%.Does not appear tympanic membrane retraction, adherence.Tympanic membrane no retraction and adherence accounted for 100% of the experimental group.Cavity dry time is 11.11+1.48 W, the shortest time is 5 weeks, the longest time is 14 weeks and cavity dry rate 100%.Tympanic membrane asle all grow well in the experimental group, the percentage of success is 100%,5 ears appear tympanic membrane perforation, tympanic membrane healing rate was 86.11%,4 ears appear tympanic membrane retraction, adherence.Tympanic membrane no retraction and adherence accounted for 88.89%.Cavity dry time is 11.25+1.46 W, the shortest time is 6 weeks, the longest time is 16 weeks,cavity dry rate 100%.On the patients who’s stape was preserved,application of autogenous cavum conchae cartilage-perichondrium compounds in tympanoplasty can improve the patients’hearing,while application of temporal fascia is not.On the patients who’s stape was destroyed,the both of graft can’t improve the patients’hearing.Conclusion:1.The autogenous cavum conchae cartilage-perichondrium compounds is easily accessible and high survival rates.Applying it in open tympanoplasty to repair tympanic membranein can maintain small tympanic cavity,reduce the tympanic membrane perforation, atelectasisand and adhesion.It’s a good material for repairing the big tympanic membrane perforation in cholesteatoma or chronic suppurative otitis media.2.Application of autogenous cavum conchae cartilage-perichondrium compounds in tympanoplasty can improve the patients’ hearing when the patients who’s stape was preserved. This material can serve as a substitute for tympanoplasty to preserve or improve patients’hearing if patients with difficulties because of economic reasons unable to use tanium ossicular prostheses.